Healthcare Provider Details

I. General information

NPI: 1689040024
Provider Name (Legal Business Name): HOPE FROM HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S MAIN ST STE B
HOPE AR
71801-6525
US

IV. Provider business mailing address

PO BOX 1387
HOPE AR
71802-1387
US

V. Phone/Fax

Practice location:
  • Phone: 870-777-6002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE4344
License Number StateAR

VIII. Authorized Official

Name: SANDRA SOOMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 870-777-6002